|22% of Eligible Young Women have Not Undergone a Mammogram Yet
By Hannah Murphy | September 28, 2022
New survey data out of Orlando Health reveals that up to 22% of eligible women have not undergone their first mammographic screening for breast cancer.
And according to an Orlando Health release on the data, many of these women (aged 35 to 44) have no intention of completing a breast cancer screening any time soon.
This news is of great concern to Nikita Shah, MD, medical oncology team leader for the Breast Care Center at the Orlando Health Cancer Institute. In an interview with Orland Health, Shah commented on the importance of understanding patients’ personal factors that could increase their risks—such as family history, dense breast tissue, race, age, etc.—when making decisions about when to begin early screening.
“African American women tend to have a more aggressive disease course, and we want everybody, regardless of their race, to be aware and get their recommended mammograms. Breast cancer is one of the few cancers where the survival rate is over 90 percent when caught early, and we know that early detection is where we can really make a difference.”
The survey data also revealed that 26% of eligible women have not had a formal conversation with their primary care physicians regarding their breast cancer risks, despite current guidelines that suggest these discussions start sooner rather than later.
Shah went on to explain how survival rates begin to decline when malignancies are discovered at more advanced stages, such as when patients become aware of palpable lumps. She reiterated current guidelines recommending that women undergo a breast cancer risk assessments starting at age 25.
To read more, go to Health Imaging.
|Senate Advances Short-term Rural Medicare Program Extensions
By Christopher Kane | Maya Goldman | September 27, 2022
Two Medicare programs that boost rural hospital payments would be temporarily extended as part of a stopgap federal spending bill that advanced past an initial vote in the Senate Tuesday.
Congress must act before the end of the week to prevent a government shutdown because the federal fiscal year ends Friday. Senate Majority Leader Chuck Schumer (D-N.Y.) unveiled the spending package Monday. Seventy-two senators supported moving forward on the bill Tuesday, giving it enough support to prevent a Republican filibuster on the final vote, which is expected this week. House leaders have yet to make public the lower chamber’s version of the continuing resolution to keep the government operating.
Under the Senate measure, the Medicare Dependent Hospital and Low-Volume Hospital programs would be extended through Dec. 17. If Congress fails to approve those extensions before Saturday, the former program would expire and the latter would revert to narrower criteria that limit hospital participation.
Congress established the Medicare Dependent Hospital program to boost financial support for rural hospitals with at least 60% of their patients covered by Medicare. About 180 hospitals—6% of all inpatient prospective payment system facilities—met the requirements this year, according to the Congressional Research Service, Congress’ nonpartisan policy institution. Medicare made about $119 million in additional payments through the program in fiscal 2018, according to a 2020 report from the Government Accountability Office. That same year, Congress extended the policy for another five years.
The continuing resolution would extend the current eligibility standards for the Low-Volume Hospital program. Congress broadened the criteria in 2018 to include hospitals with fewer than 3,800 discharges that are located more than 15 miles from the nearest inpatient hospital. Just under 20% of inpatient prospective payment system hospitals qualify for the, according to the Congressional Research Service. If Congress doesn’t pass an extension, eligibility for this program would be limited to facilities that are more than 25 miles from the nearest other hospital and that discharge fewer than 200 patients per year.
With many rural hospitals beleaguered by rising costs, provider consolidation and challenges associated with the COVID-19 pandemic, hospital groups have signaled their support for temporary funding measures as well as proposals to further extend and strengthen the two Medicare programs.
The inclusion of these Medicare rural hospital provisions in an otherwise targeted spending bill is “extremely significant,” Federation of American Hospitals President and CEO Chip Kahn said. “The big issue is hopefully not whether but rather for how long they’ll authorize the programs to go forward,” he said. The American Hospital Association supports legislation extending the Medicare Dependent Hospital and Low-Volume Hospital programs, a spokesperson said.
Lawmakers including Sen. Bob Casey (D-Pa.) introduced bills to permanently extend these two rural hospital programs. ”We are looking for additional paths to get a longer bill done, but nothing concrete at this point,” a Casey spokesperson wrote in an email. Rep. Sam Graves (R-Mo.), who authored similar legislation, is working to pass his either on its own or as part of a broader package, a spokesperson said.
The Senate spending bill does not address the continuing federal response to the COVID-19 pandemic or the monkeypox outbreak, despite a White House request for a combined $26 billion to tackle the infectious diseases.
To read more, go to Modern Healthcare.
|RSNA to Shutter Print Journals
By Dave Pearson | September 27, 2022
Collectors of medical memorabilia may want to plan on preserving the January 2023 print edition of Radiology.
That’s because the current issue, October 2022 (Vol. 305, No. 1), includes a brief message from RSNA’s board of directors that officializes a decision made over the summer to go online-only after printing and mailing that issue .
The authors tie the scheduling to Radiology’s 100th anniversary, noting the peer-reviewed periodical first rolled off the press in 1923.
RSNA says the move away from paper will “support the growth of dynamic multimedia-rich content” while responding to changing reader preferences.
“Radiology has grown exponentially over the past century, becoming the most influential publication in medical imaging,” adds Linda Moy, MD, the journal’s editor designate, in the October-edition message. “I look forward to bringing our readers the earliest possible access to relevant, time-sensitive research while reducing the environmental impact of our publication.”
The society is also taking its journal RadioGraphics all-digital after printing and mailing the November/December issue. That journal’s editor, Christine Cooky Menias, MD, says the modernization gives RadioGraphics the “opportunity to enhance the value of our articles with exceptional, seamless multimedia content—including podcasts, slides and videos—that greatly contributes to the lifelong learning goals of our readers.”
The official announcement follows three months after Radiology saw its journal impact factor skyrocket from 11.105 in 2020 to 29.146 in 2021, according to Clarivate’s Journal Citation Reports.
RadioGraphics also enjoyed a big bounce, more than doubling its impact factor between 2015 and last year. The announcement does not mention the RSNA journals Radiology: Artificial Intelligence, Radiology: Cardiothoracic Imaging, Radiology: Imaging Cancer or RSNA Case Collection.
The society board’s full official message is here.
To read more, go to Radiology Business.
|More than 100 Medical Societies Push Congress to End Destructive Cycle of Annual Medicare Cuts
By Dave Fornell | September 26, 2022
More than 120 medical societies have joined the American Medical Association (AMA) in a letter urging congressional leaders to work with the physician community to enact long-term solutions to the systemic problems in the Medicare physician payment system. The letter also called on Congress to take action to prevent scheduled Medicare payment cuts from going into effect in 2023.
Citing a new analysis of Medicare Trustees data, the letter emphasizes the key point that Medicare physician payments have been reduced by 20%, adjusted for inflation from 2001-2021. The letter also notes that physicians are the only Medicare providers not receiving an inflationary update in 2023.
The letter was sent on Sept. 22 to congressional leaders, Speaker of the House Nancy Pelosi, Majority Leader Charles Schumer, Minority Leader Kevin McCarthy and Minority Leader Mitch McConnell.
The AMA said in the letter that the undersigned national specialty and state medical societies, representing the vast majority of physicians practicing in the United States, “continue to be deeply alarmed about the mounting financial instability of the Medicare physician payment system.”
The AMA also asked Congress “to end the destructive cycle of annual Medicare cuts and to establish a permanent Medicare payment system that improves and preserves patient access to physician care.”
The letter states the instability in payments is driving many fiscal uncertainties in medical care. “Physician practices face statutory payment cuts, perennial lack of inflationary updates, significant administrative barriers, and the cumulative impact of the pandemic. The Medicare payment system remains on an unsustainable path threatening beneficiaries’ access to physicians,” the letter explains to congressional leaders.
The AMA also contends that this discrepancy between what it costs to run a physician practice and the actual payments combined with the administrative and financial burden of participating in Medicare is incentivizing the ongoing healthcare market consolidation. “The physician community stands ready to work with Congress to develop long-term solutions to the systemic problems with the Medicare physician payment system and preserve patient access,” the AMA letter states. “We appreciate the action late last year that Congress took to delay a “perfect storm” of Medicare payment cuts that, if enacted, would have severely impeded patient access to care. Unfortunately, these delayed cuts, and some new ones, will take effect in 2023.”
To read more, go to Health Exec.
|Texas Medical Association Lobs New Surprise Billing Lawsuit Taking At Tweaked Rule
By Robert King | September 23, 2022
The Texas Medical Association issued a new lawsuit Thursday taking aim at a modified rule implementing a surprise medical bill ban, with the group charging the regulation still unfairly favors insurers.
The lawsuit shows that provider groups are not mollified by a revised rule issued by the Biden administration last month. The association charged the new rule, which revises a 2021 regulation, still tilts an arbitration process for out-of-network charges too far in payers’ favor.
“There should be a level playing field for physicians and healthcare providers in payment disputes after they’ve cared for patients,” said Gary W. Floyd, M.D., the association’s president, in a statement.
The lawsuit is the latest legal fight over how to handle an arbitration process in the No Surprises Act, which outlawed surprise medical bills and called for the process to settle disputes between payers and providers on out-of-network charges.
Providers have charged that the Biden administration’s interpretation of the law tilts arbitration too much in favor of insurers. The law outlines a process where the payer and provider submit their preferred amounts for a charge and the third-party arbiter picks one. However, the original final rule released last year called on the arbiter to put a heavy emphasis on the number closest to the qualifying payment amount, which is the geographic average rate for the service.
Providers argue that the rule’s emphasis on the amount directly contradicts the law, which specifically did not include a benchmark rate. The association filed a lawsuit last October challenging arbitration. The American Hospital Association and American Medical Association filed their own lawsuits, as did an air ambulance provider group.
A federal judge sided with Texas Medical Association in a February ruling that invalidated the arbitration process. The judge said that Health and Human Services (HHS) didn’t provide adequate comment when it issued the interim final rule and the agency put too much emphasis on the qualifying payment.
HHS did appeal the ruling, but the administration also issued a new rule last month that tweaked arbitration, lessening the emphasis on the qualifying payment amount and called for the arbiter to put equal weight on other factors. However, providers appear to still be concerned that the qualifying payment amount remains a factor in arbitration.
“This is unfair to physicians, providers, and the patients we care for, so we had to seek fairness,” Floyd said in a statement explaining the need to issue another lawsuit. The association also was concerned that the new rule required arbiters to first consider the qualifying amount instead of other factors.
To read more, go to Fierce Healthcare.